Single-Incision Laparoscopic Common Bile Duct Exploration with Conventional Instruments: an Innovative Technique and a Comparative Study

Abstract

SILCBDE is as safe and efficacious as standard LCBDE in experienced hands. Choledochoscope manipulation and bile duct repair are the key skills. Long-term follow-up and further prospective randomized trials are anticipated.

Laparoscopic transfistulous bile duct exploration for Mirizzi syndrome type II: a simplified standardized technique

“…LTBDE still needs to be tailored to fit unique conditions. SILCBDE has become our standard of care for choledocholithiasis since it was developed in July 2012 [16]. Besides, we could deal with difficult gallbladders by the single-incision multiple-port longitudinal-array (SIMPLY) technique [32,33].…”

“…11 showed stone clearance and proximal bile duct dilatation. Small arrow indicates the gallbladder remnant after partial cholecystectomy Surg Endosc approach) and cholecystectomy have been described previously [16]. LTBDE shared the same surgical principles with transcystic LCBDE except the following.…”

“…Our technical details of single-incision LCBDE (SILCBDE) have been reported in a previous study [16]. This technique shares the same operative equipment and surgical principles with a standard four-incision LCBDE except a 5-mm 50-cm-long 30-degree laparoscope which helps to avoid instrument collisions.…”

T‐tube‐free single‐incision laparoscopic common bile duct exploration plus cholecystectomy: a single centre experience

“…While in SILCBDE, the choledochoscope was inserted into the umbilical port to access the CBD in a sharp angle which makes it hard to insert the choledochoscope into the CBD without the grasper's guidance. During exploration of the distal CBD, the choledochoscope accesses the CBD as an inverted U curve, which is almost impossible to insert the choledochoscope into the distal CBD without the grasper's guidance . Atraumatic grasper is always needed for guiding the choledochoscope tip into the CBD.…”

“…During exploration of the distal CBD, the choledochoscope accesses the CBD as an inverted U curve, which is almost impossible to insert the choledochoscope into the distal CBD without the grasper's guidance. 15 Atraumatic grasper is always needed for guiding the choledochoscope tip into the CBD. Through choledochoscope, stone retrieval procedure is significantly more difficult in SILCBDE.…”